Sex-Steroids

Question 1

What is the metabolism and elimination of progesterone and oestrogen?

Answer 1

Metabolised in the liver

Eliminated in the bile and urine

Question 2

State three side effects of the COCP

Answer 2

Breast tenderness
Headaches
Nausea
Mood swings
Thromboembolism
Fluid retention
Acne

Question 3

Name three drugs that reduce the efficacy of oestrogen in the COCP

Answer 3

CYP inducers:

Carbamazepine
Phenytoin
Rifampicin
St John's Wort
Anti-retroviral medications used to treat HIV

Question 4

Name two contraindications to taking the pill

Answer 4

35 and smoke
Hx of thrombosis or stroke
Severe migraines with aura
Pregnancy

Question 5

How do oestrogen and testosterone effect cholesterol levels?

Answer 5

Oestrogen raises HDL and reduces LDL

Testosterone reduces HDL and raises LDL

Question 6

When is tamoxifen used, and what is its MoA?

Answer 6

Tamoxifen - used in breast cancer to antagonise oestrogen receptors and arrest the cell cycle

Question 7

What is a risk of tamoxifen?

Answer 7

An agonist to oestrogen receptors in the endometrium, therefore can cause endometrial hyperplasia

Question 8

When is clomifene used, and what is its MoA?

Answer 8

Clomifene - used in anovulation or to restore fertility in women trying to conceive.
Competes with oestrogen receptors so the body thinks there’s less oestrogen so releases FSH and LH

Question 9

State two risks of HRT

Answer 9

• (opposed oestrogen) breast cancer
• (Oestrogen-only HRT) endometrial cancer
• Venous thromboembolism
• (Tablets) stroke

Question 10

What is the MoA of the emergency contraceptive pill containing levonorgestrel?

Answer 10

Contains synthetic progesterone which stops or delays ovulation
Has to be taken within 72hrs

Question 11

What is the MoA of the emergency contraceptive pill containing ulipristal acetate?

Answer 11

Progesterone receptor modulator which stops or delays ovulation
Has to be taken within 5 days
(Not anymore used t treat fibroids)

Question 12

What is the MoA of the copper coil as emergency contraception?

Answer 12

Spermacide

Question 13

What is the MoA of mifepristone in the termination of pregnancy?

Answer 13

Progesterone receptor antagonist, and sensitises the myometrium to contract with prostaglandins
Used in abortion clinics

Question 14

What’s contained in HRT tablets?

Answer 14

Estradiol

Medroxyprogesterone acetate

Question 15

Give the name of a drug that can be used by women on dopamine antagonists to reduce prolactin levels

Answer 15

Bromocriptine